Insurance

To maintain its flexibility and to make sure that clients can choose whichever stop loss carrier that most closely meets their needs, Fiserv Health maintains relationships with multiple direct carriers and MGUs.

Fiserv Health maintains dedicated staff responsible for the filing of stop loss claims, and Fiserv Health will coordinate with the selected carrier to ensure that all necessary filing is done. The reinsurance carriers typically require that they be notified when the claim has exceeded 50% of the specific level. When the claim has exceeded the specific level, Fiserv Health will send a copy of the check/EOB, claim(s) and enrollment form to the reinsurance carrier.

Fiserv Health’s Stop Loss reporting enables comprehensive analysis for sound financial decision making.

Fiserv Health maintains significant relationships with the highest-rated stop loss carriers and MGU’s throughout the country that provide products and solutions to meet unique customer needs.

Stop-Loss Insurance
Terminal Liability Cap (TLC)
Monthly Accumulation Cap (MAC)
Life
Long-Term Disability (LTD)

Stop-Loss Insurance
This insurance coverage provides self-funded employers with protection from losses resulting from claims greater than a specific dollar amount per covered person per year (calendar year or illness-to-illness). Types of stop-loss insurance are:

Specific or individual — reimbursement is given for claims on any covered individual which exceed a predetermined deductible, such as $25,000 or $50,000.
Aggregate — reimbursement is given for a group’s claims which in total exceed a predetermined level, such as 125% of the amount expected in an average year.

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Terminal Liability Cap (TLC)
A Terminal liability cap product offered through Fiserv Health, reduces financial exposure by establishing the maximum risk level an employer will pay for its claim run-out liability.

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Monthly Accumulation Cap (MAC) - Specific and Aggregate Advancement
Monthly fluctuations in claims can significantly influence the cash flow of small-to-medium size employer groups. Fiserv Health can access a monthly accumulation cap product that assists self-funded employers with better management of cash flow.

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Life
Fiserv Health offers a portfolio of employer-paid life insurance plans from which to choose. Employee-paid coverage, as a supplement to an employer-paid program, is also available.

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Long-Term Disability (LTD)
This insurance pays employees a percentage of monthly earnings in the event of disability.

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